Attchment D Supplier Diversity Program .pdf

Supplier Diversity Program (SDP) Prime Contractor Spending Report

Document Number/Name:

Instructions: This form must include information on your company's spending with your Supplier Diversity Program (SDP) Partner(s) and must be completed and submitted within 45 days of the end of each quarter to Commonwealth Contract Manager.

Part I Contractor Information (Required)

Contractor Company Contact Name Annual Supplier Diversity Quarterly Contract Sales Fiscal Year Name Spending Commitment % Quarter 1

(7/1-9/30) Quarter 2

(10/1-12/31) Quarter 3 (1/1-3/31)

Quarter 4 (4/1-6/30)

Total (Calculates automatically)

Part II SDP Partner Information (Required) (Insert additional lines as needed)

SDP Partner(s) Company Relationship Type Certification Type** Quarterly Spending with Supplier Diversity Partner(s) Fiscal Year Name* (Enter the name as it appears in the database) (Subcontracting or Ancillary)

(Choose One)** (Choose One)

Quarter 1 (7/1-9/30)

Quarter 2 (10/1-12/31)

Quarter 3 (1/1-3/31)

Quarter 4 (4/1-6/30)

Total (Calculates automatically)

Subcontracting Year-To-Date Compliance Check (Do not change this line) -$ Ancillary Products and Services If not in compliance, please explain why and what actions will be taken to bring your company to compliance with the annual spending commitment:

*Eligible SDP Partners can be found by searching: **All SDP Partners must possess one or more of Supplier Diversity Office Directory of Certified Businesses the following certification types:

U.S. Dept of Veterans Affairs Vendor Information Pages MBE - Minority Business Enterprise

WBE - Woman Business Enterprise Part III Under the pains and penalties of perjury I certify M/WBE - Minority and Woman Business Enterprise that the information provided in this report is accurate. SDVOBE - Service-Disabled Veteran-Owned Business Enterprise Name VBE - Veteran-Owned Business Enterprise Title M/NPO - Minority Non-Profit Organization Phone W/NPO - Women Non-Profit Organization Email M/W/NPO - Minority and Women Non-Profit Organization Date DOBE - Disability-Owned Business Enterprise Form updated 06/28/2021 LGBTBE - Lesbian, Gay, Bisexual or Transgender Business Enterprise https://www.diversitycertification.mass.gov/BusinessDirectory/BusinessDirectorySearch.aspx https://www.vip.vetbiz.va.gov/

FORM INSTRUCTIONS

Overall Contractors are required to file a "Supplier Diversity Program (SDP) Spending Report" form. This requirement includes contractors who have already been certified by the Supplier Diversity Office (SDO) as a diverse business. The Supplier Diversity Office and contracting department reserves the right to contact SDP Partners at any time to request that they attest to the amounts reported to have been paid to them by the Contractor.

Parts of the Form that Require Completion Please complete the fields shaded in yellow.

Part I - Contractor Information

● Contractor Company Name: Enter your company name.

● Contact name: Enter the sum of all sales under the contact made during the quarter.

● Annual Supplier Diversity Spending Commitment %: Enter your company's SDP Plan commitment percentage submitted in your Bid Response or established through negotiation.

● Quarterly Contract Sales: Enter the sum of all sales under the contact made during the quarter.

Part II - Contractor's SDP Partner Information All SDP Partner(s) listed on the form must be certified in one or more of the certification categories listed on Page 1 of this form. Links to searchable databases of eligible SDP partners are also available on Page 1 of the form.

Contractors certified by the Supplier Diversity Office or another recognized certification organization may not list their own organization as an SDP partner.

● Certification Type: Select the partner's certification type from the menu. For partners with multiple certification types, please select the one that is highest on the dropdown list.

● Relationship Type: Select one of the following types:

- Subcontracting, defined as a partnership in which the SDP partner is involved in the provision of products and/or services to the Commonwealth. Such relationships typically, but not always, involve a formal written agreement between the SDP partner and the prime contractor.

- Ancillary Products and Services, defined as a business relationship in which the SDP partner provides products or services that are not directly related to the prime contractor’s contract with the Commonwealth. In most cases, this type of partnership is related to the prime contractor’s general business needs. Note: If the Commonwealth receives a portion of the products or services that are provided through this relationship type, the portion received by the Commonwealth may be reported as subcontracting while the remainder of the amount may be reported as ancillary products and services.

● Quarterly Spending with Supplier Diversity Partner(s): Enter the amount (as an exact dollar figure) that your company expended with SDP partner(s) during the quarter.

Additional Resources

● More information about the Supplier Diversity Program (SDP) is available at www.mass.gov/sdp

● More information about supplier diversity certifications is available at www.mass.gov/sdo

SDP Spending Report